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Evaluation of tuberculosis underreporting in Greece through comparison with anti-tuberculosis drug consumption.

Abstract
Surveillance is an integral part of tuberculosis (TB) control. Greece has a low TB notification rate, but there are doubts about underreporting. Examining anti-TB drug consumption is a way to validate the results of surveillance and estimate TB burden in the country. We used surveillance data from 2004 to 2008 to calculate the average prescribed treatment duration with the first-line anti-TB drugs isoniazid, rifampicin, ethambutol and pyrazinamide. We then obtained the best available data on consumption of these drugs, and calculated the number of treated cases to which these quantities correspond. We thus estimated underreporting at around 80% (77-81%), and annual TB incidence at about 30 cases per 100,000 population, five times over the notification rate. Underreporting was found to be constant over the study period, while incidence followed a decreasing trend. In addition we estimated that one person receives chemoprophylaxis for latent tuberculosis infection (LTBI) for every three TB cases. These results indicate the need for a comprehensive plan to improve TB surveillance and TB contact tracing in Greece, especially in light of the economic crisis affecting the country since 2009.
AuthorsTheodore Lytras, Georgia Spala, Stefanos Bonovas, Takis Panagiotopoulos
JournalPloS one (PLoS One) Vol. 7 Issue 11 Pg. e50033 ( 2012) ISSN: 1932-6203 [Electronic] United States
PMID23185524 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • Antitubercular Agents
  • Prescription Drugs
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin
Topics
  • Antitubercular Agents (economics, therapeutic use)
  • Epidemiological Monitoring
  • Ethambutol (therapeutic use)
  • Greece
  • Humans
  • Isoniazid (therapeutic use)
  • Latent Tuberculosis (prevention & control)
  • Prescription Drugs (therapeutic use)
  • Pyrazinamide (therapeutic use)
  • Rifampin (therapeutic use)
  • Tuberculosis (drug therapy, economics, epidemiology)
  • Tuberculosis, Multidrug-Resistant (drug therapy, epidemiology)

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